Professional Documents
Culture Documents
NCC/NSS NO Is Orphan NO
Caste Category OPEN Student has internet YES
connectivity
Handicap(Divyang) NA
Contact Details
Pincode 401305
Permanent/Native Address
Pincode 401305
Exam Details
Declaration by Student
I hereby declare that, I have read the rules related to admission and the information filled in by me in this form is accurate
and true to the best of my knowledge. I will be responsible for any discrepancy, arising out of the form signed by me and I undertake
that, in absence of any document the final admission will not be granted and / or admission will stand cancel.
I have permitted my son / daughter / ward to join your college.The information supplied by him / her is correct to the best of
my knowledge. I have acquainted myself with the rules and fees, dues to my son / daughter / ward and see that he / she observes.
Admission Clerk
Admission Committee
Accountant / cashier
Registrar/Office
superintendent
Other Details
VIDYAVARDHINI’S
A.V.COLLEGE OF ARTS, K.M. COLLEGE OF COMMERCE AND E.S.A. COLLEGE OF
NAVGHAR ROAD, BESIDE VASAI ROAD RAILWAY STATION, VASAI (W), DIST. PALGHAR(MS)
401202.
TO BE FILLED BY A STUDENT (Online & submit printout along with admission form) www.amanmovement.org
<http://www.amanmovement.org>
Fields marker with* are compulsory.
v If you do not have an Email address please create on before you fill in this form.
v If your mother or father or guardian does not have a phone or a mobile phone or email then please give the
numbers/email of their friends or relations or neighbors.
v If you do not have a mobile number, then please give the mobile number of your friend in the college.
After filling this form successfully you will receive the Student’s Anti Ragging Undertaking (Affidavit) and the Parents
Anti Ragging Undertaking (Affidavit) in you Email. Please print both the Undertakings (Affidavit). Sign them yourself,
request your parents to read the details and request them to sign their undertaking (Affidavit) and then present both
at your college at the time of registration each year.
Students Personal Details:
Name :
SAVE PRIT VIKAS AMRITA
Student’s Mob. No. : 9359783495 Incase of Emergency contact Mob. No. : 9892726082
Parent/Guardian Details:
Parent/Guardian Name:
Parent/Guardian Address :
Course Details :
Under Graduate of Post Graduate : Undergraduate
Note : Online Registration of this form is compulsory for all the students.
GROUP INSURANCE FORM ATTACHED WITH ADMISSION FORM
VIDYAVARDHINI’S
A.V.COLLEGE OF ARTS, K.M. COLLEGE OF COMMERCE AND E.S.A. COLLEGE OF
NAVGHAR ROAD, BESIDE VASAI ROAD RAILWAY STATION, VASAI (W), DIST. PALGHAR(MS) 401202.
“YUVA RAKSHA”
(Group Insurance Scheme for Students)
STUDENT’S REGISTRATION FORM
(Copy to be submitted alongwith the Admission Form)
5) Blood Group : B+
6) Name of Guardian :
7) Guardian Mobile No :
Note : Subject to be changed as per the Insurance is circular, claim will be start form the actual
payment of premium to insurance company not from the date of Admission.
Received from student (Name SAVE PRIT VIKAS of BACHELOR OF COMMERCE (BCOM) - 5 course)
Premium Rs. 0.00/- against the Receipt No. _________________________ dated __________________
Head
Institute/Department/College Seal/Stamp with Signature
(College to preserve the slip along with Admission form)